New license plate would promote outdoor recreation, support environmental education programs; 900 buyers needed to start

A new "Let's Go Outside" license plate is being offered to give Kentucky motorists the opportunity to promote the health and environmental benefits of outdoor recreation.

First Lady Jane Beshear unveiled the license plate June 10. She said that encouraging children to play outside will help improve their health and noted that "Kentucky has one of the highest childhood obesity rates in the nation," reports to The Lane Report.

Proceeds from the specialty plate will support the work of the Kentucky Environmental Education Council, including coordinating the Kentucky Green and Healthy Schools program and certifying professional environmental educators.

“Kentuckians have said in surveys that children not spending enough time outside is a major concern,” KEEC Executive Director Elizabeth Schmitz said. “One of our goals is to encourage children to embrace the outdoors and to teach them the importance of a clean environment for our health and preservation."

The Kentucky Environmental Education Council needs 900 applications, each accompanied by a $25 donation, before any plates will be manufactured.

Submitting the application does not obligate you to purchase the plate, but your donation will be credited toward the purchase of a plate once they are in production. If not enough applications are received, your $25 will be considered a tax-deductible donation.

A link to download the application is available at www.keec.ky.gov/LetsGoOutside.

Use of walking aids is increasing as population ages; study debunks notion that using them makes falls more likely

In the last 10 years, the use of walking aids—such as canes, wheelchairs and scooters—has increased by half, and is expected to grow as the number of seniors doubles in the next 35 years.

Research has shown a correlation between use of walking aids and falling, which is the leading cause of death resulting from injury for people 65 and older. However, a recent study in National Health and Aging Trends shows that people who employ mobility devices are not more likely to fall than those who do not use such devices.

Previous research that indicated the use of walking aids might increase the likelihood of falling "only looked within groups of people . . . who are already more likely to fall," said researcher Nancy Gell, assistant professor of rehabilitation and movement science at the University of Vermont. "This study is the most in-depth since 2004 and shows no link between mobility devices and falls as previously thought."

Gell reports that 16.4 percent of seniors use a cane, 11.6 percent use walkers, 6.1 percent use wheelchairs and 2.3 use scooters. Those who use canes are more likely to say they refrain from certain activities because of the fear of falling. "For many people, a cane is the appropriate device for their circumstance to stay mobile," Gell writes. "However, if worry about falling continues despite using a cane for support, it is worth considering a different device in order to be as active as possible."

"The question is if it's better to be active or sedentary and not risk falling," Gell writes. "We think it's better to be active."

How do diet and exercise influence risk of diabetes? Diet seems more important

Many people think exercising and eating properly are interchangeable, but a paper by Edwards Weiss, associate professor of nutrition and dietetics at Saint Louis University, asserts that exercising and restricting diet results in specific and cumulative benefits in reducing the risk of Type 2 diabetes. According to the 2013 Kentucky Diabetes Report, 6.9 percent of Kentucky adults have diabetes.

Participants in the study were sedentary, overweight middle-aged men and women who reduced their weight 6 to 8 percent through calorie restriction, exercise or both. Researchers measured their insulin sensitivity levels, which determines risk of diabetes. "Your blood sugar may be perfectly normal, but if your insulin sensitivity is low, you are on the way to blood sugar issues and, potentially, Type 2 diabetes," Weiss said.

The researchers measured twice the improvement of insulin sensitivity in the group of participants who both exercised and restricted their diets than in the other two groups. Weiss notes that exercise helps regulate glucose, even if a person isn't losing weight as a result. The researchers also found that exercised-induced weight loss didn't regulate glucoregulation more effectively than calorie restriction. "What we found is that calorie restriction, like exercise, may be providing benefits beyond those associated with weight loss alone," Weiss said.

Weiss said that though it might seem obvious that a combination of diet and exercise would engender the best results, "there are a lot of people who believe that if they maintain a healthy weight, it doesn't matter what they eat. And others have an appropriate food intake but don't exercise."

Mount Sterling follows lead of another KentuckyOne Health hospital, in Bardstown, to host monthly 'Walk With a Doc'

Saint Joseph Mount Sterling is the second KentuckyOne Health hospital to host monthly "Walk With a Doc" events as part of a nationwide program that promotes walking as a great way to improve your health, while at the same time offering a place to get to know your local physicians in an informal setting as you walk together. The program also offers a complimentary health screenings at the event, says a news release from KentuckyOne Health.

Flaget Memorial Hospital in Bardstown, also part of KentuckyOne Health, began its "Walk With a Doc" program in March.

"According to America Walks, brisk walking has been shown to reduce body fat, lower blood pressure, increase high-density lipoprotein and even reduce risks of bone fracture. Not only that, it is also associated with lower mortality rates from cardiovascular disease and cancer," says the release.

The Mount Sterling walks begin at 9 a.m. on Saturday, April 25 at Easy Walker Park, located at 1395 Osborne Rd. For more information call 859-497-5556.

Chiropractors cite research recommending 'conservative treatments' for low-back pain before prescribing painkillers

Recent research has questioned the effectiveness of acetaminophen for the treatment of spinal pain. In response, the American Chiropractic Association recommends that patients and health-care providers take a conservative approach to back pain. According to a study published in the British Medical Journal, the commonly administered painkiller isn't helpful for diminishing low-back pain.

According to a report released by the federal Centers for Disease Control and Prevention, Kentucky ranks among the top five states for opiate painkiller prescriptions written per 100 people, Deborah Highland reports for the Bowling Green Daily News.

"Research supports the use of more conservative treatments as a first-line defense against pain," said ACA President Anthony Hamm. "This sensible approach not only reduces healthcare costs but may also help some patients avoid riskier treatments altogether," he said in a news release that has exercise tips, posture recommendations and injury prevention techniques to help people maintain healthy backs throughout life.

Researchers discuss physical activity as a way of maintaining or improving health; daily walking is still the best exercise

By Melissa Patrick
Kentucky Health News

Obesity worsens the damage that arthritis does to joints, but simply telling patients to go home and diet and exercise is not working, and health care providers must proactively monitor their patients and help them find affordable solutions to succeed. And daily walking is still the best exercise.

Those were examples of research findings discussed at the 10th annual Center for Clinical and Translational Science conference sponsored by the University of Kentucky on March 25. More than 700 researchers, students, policymakers and guests discussed research with a focus on physical activity across the lifespan.

Stephen Messier, professor and director of a biomechanics laboratory at Wake Forest University, said obesity has a significant effect on joint health, particularly osteoarthritis, which he said is quite painful. He called for closer attention to obese patients with arthritis.

He said a study found that a combination of diet and exercise over an extended period of time offers the best results for less pain and less disability. He said that a separate study found those who lost 10 percent of their body weight had the most "significant outcomes" related to function, which included walking speed.

The conference featured 31 oral presentations and 270 poster presentations, addressing a vast array of topics including physical inactivity in children, physical inactivity in chronic disease and biomedical informatics.

"The conference was designed to raise awareness of the science behind the benefits of exercise and the dangers of physical inactivity," Charlotte Petterson, professor and associate dean of research in the College of Health Sciences, who chaired this year's conference, said in a UK press release.

The keynote speaker, Duke University medicine professor William E. Kraus, encouraged walking as a proven and simple activity that can improve health and actually extend life. "Fitness always trumps fatness," he said, noting that a "culture of convenience" and conditions of built environments, such as absence of sidewalks, deter people from physical activity.

Research on fourth and fifth graders in two Clay County schools, while in the early stages of analysis, found that obesity and inactivity begins early.

Karyn Esser, professor of physiology at the UK College of Medicine, said her research was examining the circadian rhythms and physical activities of students because changes in natural circadian rhythms "can create pre-cursors to disease" in just seven days, even in healthy young people. She said her study is intended to help schools improve students' health by adjusting meal times and offering physical activities to best coincide with circadian rhythms.

The data for Esser's study was gathered through electronic devices that the 136 students wore for seven days to measure activity, heart rate and skin temperature. The students also kept a daily journal to record their activities. So far, Esser said, the data show 33 percent of the students are considered obese, their initial blood pressure measurements are on the high end of normal, and the students are less active on weekends and nights than during the school week.

Another UK study found that students who are more active during the school day do better in mathematics.

Alicia Fedewa and Heather Erwin of the College of Education said they found that increased physical activity levels "significantly improved" math scores and slightly improved reading scores of the students who got an extra 20 minutes of movement on each school day. They recommended two short 15-minute recesses per day, rather than one long one. They also said that classroom "energizers" and stability balls also help students with these behaviors.

The researchers said many studies show that students who participate in recess and physical education during the school day are more focused and less fidgety, show less listlessness, and have better overall classroom behavior. They said more controlled studies need to be conducted, but said most studies to date have found that fit kids have less anxiety and better overall well-being. Also, a regimen of consistent physical activity is best for kids with attention deficit hyperactivity disorder (ADHD).

Beshear cites signs toward better health: kids are more active and getting more dental care; adults are getting more screenings

Kentucky Health News

Kentucky is moving toward achieving the broad, ambitious goals for better health that Gov. Steve Beshear laid out when he started the "Kyhealthnow" initiative in February 2014, his office says.

"More Kentuckians have health insurance, are covered by smoke-free policy, can access physical activity resources, seek care for heart disease and cancer prevention, and get dental services" since the initiative began, Beshear said in a press release.

The program builds on federal health reform, which has made Medicaid or private insurance available to hundreds of thousands of Kentuckians, many of whom were previously uninsured and unable to afford health coverage. According to a Gallup Poll released in February, 9.8 percent of Kentucky’s population is uninsured, down from 20.4 percent in 2013.

Kyhealthnow targets seven major health goals to be met by 2019, focusing on increasing health insurance coverage; reducing the smoking rate and tobacco use; lowering the prevalence of obesity; lowering cancer deaths; reducing cardiovascular disease; treating and reducing dental decay; and reducing drug overdoses and mental health issues in Kentucky.

The report said more adults have been screened and identified as having high blood pressure and are able to control their hypertension, and more adults have had their cholesterol checked.

Significantly more children on Medicaid are being seen by dentists, and the number of children enrolled in Medicaid receiving two fluoride dental varnishes per year has increased. The state has given money to five health departments for dental-hygiene programs, and will fund five more this year. "These programs broaden access to hygiene services, such as cleanings, screening and referrals, by providing staff and resources to supply mobile units to deliver care in schools," the release said.

School districts are showing an increase in the amount of time devoted to physical activity, the state reports. The Comprehensive School Physical Activity Program has been implemented at proficient or distinguished levels at all grade levels in 515 of the state's 746 elementary schools, 186 of the 329 middle schools and 109 of the 228 high schools. Also, more schools report they are using body-mass index data to inform school wellness policy.

The state health department is using federal funds to implement physical activity and obesity-prevention curricula in early-childhood care centers. "The goal is to develop healthy habits in children before the age of 5 and prevent obesity," the news release says.

To increase physical activity and deter obesity among older children and adults, the state is establishing “trail towns.” Morehead and Olive Hill were recently certified by the state Office of Adventure Tourism and eight more are expected to be certified this year. The Dawkins Trail, an ongoing rail-to-trail project in Eastern Kentucky, has reached a length of 18 miles.

Diabetes management has improved among adults, and a study of Medicaid patients showed an overall decrease in those with poor diabetes control, the release said. State employees now have easier access to the nationally recognized Diabetes Prevention Program, which helps people who are at risk of developing diabetes reverse the onset of the disease.

Dr. Stephanie Mayfield, the state health commissioner and vice chair of Kyhealthnow, has emphasized the importance of reducing tobacco use to make Kentuckians healthier. Beshear has expanded the ban on tobacco products and e-cigarettes on executive branch properties, making Kentucky one of only five states in the country with such a policy. Smoking bans exist in 24 communities, 37 school districts and 51 college or university campuses.

Kyhealthnow, chaired by Lt. Gov. Crit Luallen, includes people from many areas of state government who develop innovative strategies for addressing the state’s health woes and challenge local governments, businesses, schools, nonprofits and individuals to take meaningful steps toward improving health in their communities, the release said.

Grant will fund Lexington signs, maps to encourage walking

A $182,000 grant will fund a pilot project in Lexington to encourage citizens to walk more, by erecting way-finding signs for pedestrians and updating walking maps.

The new Walk Lexington program will also feature signs that tell people how easy it is to get from one spot to another such as "It's only two minutes to the library." The signs are used to help people realize that walking is often faster than driving.

The grant is from the John S. and James L. Knight Foundation, which awards grants to programs in cities where the Knight brothers once owned newspapers, including the Lexington Herald-Leader.

A Herald-Leader report on the grant indicted that the recipient is the NoLi Community Development Corp., a nonprofit trying to make the North Limestone corridor a more livable place, through the Blue Grass Community Foundation, which announced it.

Churches add fitness facilities as part of ministry outreach, community service; Louisville's Walnut Street church led the way

More churches are beginning to see health and fitness facilities as potential ministry niches, which can positively influence surrounding communities. Walnut Street Baptist Church in Louisville was a pioneer, building a six-story health facility including bowling alleys in the late 1950s and early 1960s, church consultant George Bullard told Jeff Brumley of Baptist News Global.

Now health ministries have been "making a comeback as a variety of social and religious trends in America converge," Brumley reports. "There is absolutely an opportunity for new forms of church centered around fitness," said Travis Collins, the director of mission advancement and Virginia regional coordinator for Fresh Expressions US.

Creative Commons photo by jerronlife

Secular organizations that promote fitness often promote health-focused ministries and programs. For example, Houston-based nonprofit Health Fitness Revolution released a list of the 20 Fittest Churches in Texas. Samir Becic, the organization's founder, said, "Spiritual awareness is one of the key components of healthy lifestyle that impacts the whole body and rejuvenates the spirit." Many of the churches on the list have fitness classes, nutrition and senior programs and sports leagues. Some also have facilities for fitness and health.

Second-Ponce de Leon Baptist Church in Atlanta has a 70,000-square-foot facility with a indoor pool and track, weight room, cardio center and even personal trainers. The church website says, "It is our desire that all who use our facility or participate

in our activities will have the opportunity to hear that Jesus Christ loves them and desires to have a personal relationship with them," the church website says.

Besides building fitness centers, churches are promoting good health in other ways. "Another wave in recent years is that of church members, often led by pastors, uniting to lower blood pressure, drop pounds and tone up as a team," Brumley writes. Christianity Today reported in 2013 that churches from Indiana to Virginia were making fitness pledges, and 250 members of Central Baptist Church in Northern Virginia said they lost 12,000 pounds collectively. (Read more)

Another study suggests that lack of walking and other physical activity damages blood vessels and causes many health issues

If you are looking for a reason to commit to daily exercise in 2015, here are two: The U.S. surgeon general says most of us only exercise about half the recommended amount to be healthy, and a new study shows that this lack of activity damages our blood vessels, which contributes to much of what ails us.

Research at the University of Missouri School of Medicine, published in Medicine and Science in Sports and Exercise, found that going from high (10,000 steps a day) to low levels of daily physical activity (5,000 steps a day) for just five days decreases the function of the inner lining of the blood vessels in the legs, according to a news release from the university.

“The impairment we saw in just five days was quite striking,” Paul Fadel, associate professor of medical pharmacology and physiology at the university, said in the release. “It shows just how susceptible the vascular system is to physical inactivity.” Previous studies have found that a decrease in blood-vessel function is linked to early cardiovascular death and hypertension.

Kentucky is the ninth most inactive state, with almost one-third (30.2 percent) of Kentuckians reporting in a national survey that they did not engage in physical activity or exercise during the previous 30 days other than doing their regular jobs, according to the State of Obesity report.

A collective New Year's resolution by Kentuckians to increase their physical activity, if kept, would help improve almost every health issue that plagues our state: obesity, diabetes, high blood pressure, heart disease. Kentucky ranks fifth in obesity, 17th in diabetes and fifth in hypertension, and is projected to have more than 1 million cases of heart disease by 2010, the report says.

“Inactivity is typically going to lead to people being overweight and obese,” Fadel said. “The next step after that is insulin resistance, which leads to Type 2 diabetes and cardiovascular disease.”

So, how much activity do we need to keep our blood vessels healthy? 10,000 steps every day, says the surgeon general. But the reality is that most of us only take 5,000 steps a day, which is considered a low activity level. The research for this study is based on 30 minutes of moderate activity a day.

“We need to teach and explain to people about the physiology of their bodies and the physiology of the disease process and help them understand that inactivity plays a foundational role in the disease process,” John Thyfault, associate professor of nutrition and exercise physiology at the university, said.

“Then we give them behavioral tools, like pedometers, to monitor and help them achieve higher physical activity so they start to see and feel health improvements. These studies are proof we need to get people to understand their activity every day plays a role in their health, and that their health is not simply a matter of body weight and how they look in the mirror.”

Spending bill allows schools that show 'hardship' to vary from requirement to serve 100 percent whole grains

By Melissa Patrick
Kentucky Health News

The massive 2015 spending bill signed by President Obama Dec. 16 includes a provision to help schools struggling with the whole-grain and sodium requirements that are part of the Healthy, Hungry-Free Kids Act. It did not allow, as House Republicans had hoped, schools to opt out of the healthier school meal standards if they lost money on meal programs over a six-month period.

Beginning with the 2014 school year, schools had to serve 100 percent whole grains in their meals and snacks, and also follow the first restrictions on sodium, or salt. The sodium restrictions were scheduled to get progressively stricter over the years, with the next move set for 2017.

The law allows schools that demonstrate the rule is a "hardship" to continue serving 50 percent whole grains. It also says sodium standards cannot be tightened until the "latest scientific research establishes the reduction is beneficial for children," Mary Clare Jalonick reports for The Associated Press.

Some schools say they have had trouble complying with these requirements because many of the affordable whole grain pastas have proven difficult to cook en masse and the whole-grain versions of many foods, like biscuits and tortillas, simply don't taste the same.

On salt, schools say budgeting the allowed amounts among meals, snacks and a la carte items is often a challenge. The issue hit Anderson County schools earlier this year when they couldn't find a low-sodium ketchup; their solution was to not offer ketchup. Parent and student complaints prompted a reversal of that move, but to do that, sodium had to be removed elsewhere in the menu.

The new law won't have much effect on Fayette County Schools, Director of School Nutrition Michelle Coker said in a telephone interview. "Basically, we use 100 percent whole grains in everything," she said. "But there are products, like tortilla shells, that aren't as flavorful and this gives us some flexibility."

Fayette County has transitioned slowly to whole grains over the last five to six years to help students adjust to them, Coker said, and as whole-grain products have become "tastier" the transition has not been an issue.

"Whole grain pasta products have come a long way," Coker said. "Three to four years ago they were dark, but now it is difficult to tell the difference. Kentucky has really good vendors."

Coker, a registered dietitian, welcomed the possible delay in lower salt limits, saying most students are active and involved in sports and shouldn't need such low sodium restrictions. "These kids are growing and need electrolytes," she said.

The School Nutrition Association, a group that represents both school nutrition directors and the food companies that produce foods for schools, wanted even deeper rollbacks than the spending bill included, but said it "strongly supports" the budget-bill language.

Alabama Rep. Robert Aderholt, chairman of the House subcommittee that oversees nutrition issues, said the whole-grains waiver is "the best bill that we are going to get" as long as Democrats are in control the Senate, Jalonick reports.

Republicans will control both houses of Congress next year, so the battle is far from over, and the overall law governing child nutrition policy, including school lunches, expires next year and will require legislation to be renewed, Jalonick notes.

First Lady Michelle Obama, champion for improving school's nutrition and decreasing child obesity, said this summer that she would fight "to the bitter end" to make sure kids have good nutrition in schools.

Anti-obesity program targets preschoolers, will expand to rural Kentucky next year

By Melissa Patrick
Kentucky Health News

The latest America's Health Rankings report ranks Kentucky as the 47th healthiest state, a fall from 45th last year. With the exception of one year, Kentucky has found itself ranked as one of the bottom 10 states since the rankings began in 1990.

How does Kentucky even begin to dig itself out of this hole?

The long-term answer will likely be found in changing the health habits of our children, which is exactly what the Kentucky Department for Public Health is trying to do by participating in the National Early Care and Education Learning Collaborative Project, a childhood obesity-intervention program that targets child-care and education providers for preschool children.

Kentucky is one of a few states in the program, and will be expanding next year to locations in southeastern and western Kentucky.

“Sustained well-being is made possible when people learn the lessons of a healthy lifestyle early on,” Health Commissioner Stephanie Mayfield said in a press release. “By working with the early-care and education community, we are able to reach many of Kentucky’s young children and help them build the foundation for being healthy and active.”

Child obesity has been considered a national epidemic, with 17 percent of U.S. children considered obese and almost 32 percent considered overweight. Kentucky ranks eighth in child obesity, with 19.7 percent between the ages of 10 and 17 obese, according to the Trust for America’s Health and the Robert Wood Johnson Foundation’s annual "The State of Obesity" report.

The same report says nearly 16 percent of low-income children under the age of 5 in Kentucky who are enrolled in federally funded maternal and child health programs are characterized as obese. That is the target population for the project.

The project, which is part of a multi-state pilot funded by the federal Centers for Disease Control and Prevention and managed by Nemours Children’s Health System, aims to fight back against this epidemic by placing a focus on improving nutrition, increasing physical activity, reducing screen time, and providing breast-feeding support through a national curriculum and learning collaborative method with early care and education providers, according to a Nemours press release.

Kentucky received a $275,000 grant from Nemours to be a part of this project. Currently, nine states participate in the National ECELC Project.

The first phase of the Kentucky Early Care and Education Learning Collaborative includes 65 early care environments in Jefferson County, Fayette County and Northern Kentucky. The programs represent Head Start classrooms, non-profit and commercial child care, private preschool and public preschool settings and has reached 7,559 children.

Phase II of the project allows funding to launch four more collaboratives in 2015. The first two will launch in March: a second one in Jefferson County, and one in Laurel County, which will include an invitation to the early-care programs in the surrounding counties to participate. The second launch will happen in October, but these locations, which will be located west of Interstate 65, have not yet been determined.

Child-care centers in the program "participate in group learning and action planning and have access to technical assistance, tools, materials and resources to aid in their continuous improvement. Information is shared within and between teams," the state press release said.

The project is not designed to measure child outcomes, which would add tremendous cost in both time and money to this project, Rebekah Duchette, Kentucky's project coordinator, said in an e-mail. But they are seeing positive results from the program.

"We are seeing changes in environments, policies and practices around nutrition, physical activity, screen time, breastfeeding, family engagement and juice consumption," she said.

One of the missions of the project is to implement and influence policy around childhood obesity. Kentucky has taken this charge to heart both at the program level as well as the state level.

"We are working on some exciting policy changes and equally exciting clarifications for programs. At the program level we see programs implementing policies that go above what the state of Kentucky requires in child-care regulations: centers that are incorporating fresh fruits and vegetables, changing to seasonal menus that expose children to a larger variety of foods, eliminating pre-fried and fried foods from menus, adding more physical activity to the daily schedules and using physical activity time as learning time," Duchette said.

"As part of our sustainability planning we are working with early education stakeholders to develop a proposed list of child care regulations that support the best practices in healthy behaviors. Additionally, we are working with various branches of the state that regulate child care to clarify some existing regulations and send a consistent message to early care programs about how to implement best practices and stay in compliance with all state and local regulations."

“Reaching kids early is the key to combating childhood obesity,” Debbie I. Chang, vice president of policy and prevention at Nemours, said in the press release.

Five things you can start doing today to decrease your risk of getting diabetes, which affects one of every 10 Kentuckians

By Melissa Patrick
Kentucky Health News

Diabetes is a real problem in Kentucky and one that is not projected to get any better. You may be at risk of getting it, but there are things you can do to decrease your risk of becoming diabetic.

"Type 2 diabetes is still entirely preventable with certain lifestyle changes," Dr. Manny Alvarez writes for Fox News. "I always preach to my patients the importance of exercise and diet."

Kentucky ranks 17th in diabetes. One in 10 adult Kentuckians have been diagnosed with it and 40 percent of Kentuckians age 40-74 have pre-diabetes, according to the state Department for Public Health.

Even more worrying is the 2014 "States of Obesity" report that projects a 51 percent increase of Kentuckians with diabetes by 2030, going from an estimated 400,000 in 2010 to almost 600,000 in 2030.

Alvarez cites a study that identifies five simple habits to cut your risk of developing diabetes by as much as 80 percent:

1. Have a healthy diet, including lots of fruits and vegetables
2. Exercise three times a week for at least 20 minutes.
3. Maintain a normal body weight, which means a BMI between 18.5 and 24.9
4. Don't smoke.
5. Consume alcohol in moderate amounts.

Maintaining a normal body weight is the single most effective factor to prevent getting diabetes, according to the study, Alvarez reports. "Men of normal weight were 70 percent less likely to develop diabetes than overweight or obese men, while normal weight women were 78 percent less likely to develop diabetes."

But that doesn't mean overweight people don't benefit from incorporating these healthy lifestyle changes. "Overweight people who adopted just one of the other healthy lifestyle factors, such as exercising three times a week, could still reduce their risk of diabetes," Alvarez writes.

These suggestions should offer some hope to Kentuckians as lifestyle changes are things we have some control of and often come at little to no cost.

Study finds Tylenol and rest not best remedy for an aching back; movement, breathing and a strong body is the answer

Tylenol and rest as a cure for back pain is a thing of the past, instead the preferred treatment is to keep moving, according to a news release from the Saint Louis University Medical Center.

Seventy-five percent of people experience at least one episode of back pain in their lifetime and Chris Sebelski, DPT and associate professor of physical therapy and athletic training atSaint Louis University, says that researchers still struggle with understanding what causes it and how to treat it,

And to add to this confusion, a study released earlier this year by Australian researchers found that acetaminophen, brand name Tylenol, appears to make no difference in helping patients manage back pain, according to the release.

“It may be that acetaminophen helps but doesn’t completely eliminate back pain, or it may work for some people and some injuries, but not others,” Sebelski said in the release. The answer is to "broaden our approach to include more than Tylenol and a few days rest."

America's sedentary lifestyle which often includes desk jobs, hours in front of a screen and lack of physical activity is a recipe for stiff muscles and achy backs.

“Instead of sitting at your desk for hours, change positions, stand for 20 minutes, or go for a walk and talk to someone. Movement will keep you healthy and allow you to adjust," Sebelski said in the release.

And the level of movement doesn't have to be a huge time or energy commitment; "you don't have to join a gym," he said.

People with back pain should also work work on strengthening the whole body, Sebelski says. Strong legs, limber hips and a strong trunk "will keep you from overtaxing lower back muscles to compensate for weakness elsewhere in the body."

Sebelski also emphasises the importance of breathing which surprisingly also strengthens groups of muscles within your trunk.

“Deep breathing really activates key muscles in your trunk,” Sebelski said. “Talk. Laugh out loud. Do cardio. Do yoga. Do things that force you to breathe. This will help your back stay healthy.”

The best medicine for an aching back, says Sebelski, is "active rest."

“There’s no such thing as just ‘rest,’ Sebelski said. “At rest, muscles weaken; moving builds strength. Think about it in terms of alternating movement and active rest.

“Even after an injury, while you don’t put yourself at risk by pushing yourself too hard before you’re ready, you also don’t just go to bed. You do what you can do. Even something as simple as walking offers significant benefits.”

Students at elementary school in Bowling Green create walking trail to promote health and education

Ribbon cutting ceremony for walking trail
Wednesday, Oct. 22 at T.C. Cherry Elementary School.
Photo: Miranda Pederson/Daily News

Students at T.C. Cherry Elementary School in Bowling Green came up with the idea of creating a walking path around their school in April and when they showed up for school in August, it had become a reality, Laurel Wilson reports for The Daily News in Bowling Green.

The Leadership Bowling Green class "took it to the next level," T.C. Cherry Principal Kory Twyman told Wilson.

The Leadership Bowling Green program is a nine- month leadership-development program coordinated by the Bowling Green Area Chamber of Commerce. Over the summer, the 2014 leadership class constructed a 1/3-mile gravel path around the school for its class project - bringing to fruition a project chosen because it "would have the largest impact on the community by promoting health and education," class president Jason Marshall told Wilson.

Seven signs along the path reinforce the seven habits students learn as part of "The Leader in Me" curriculum: Be proactive; begin with the end in mind; put first things first; think win-win; seek first to understand, then to be understood; synergize; and sharpen the saw.

Students can take pride in the fact that they helped make the walking trail happen, Twyman.told Wilson. “It made them aware that even as 9-, 10-, 11-year-old children, they have a voice and people are listening,” he said.

Experts suggest ways to win public-policy changes to fight obesity

Though the obesity epidemic shows signs of stabilizing, it still carries national security risks—negatively affecting education, agriculture and transportation—and public policy change can incredibly important in reducing obesity, Richard Hamburg, deputy director of Trust for America's Health, said at the Southern Obesity Summit in Louisville Oct. 7.

Kentucky and 42 other states have adult obesity rates of at least 25 percent, according to The States of Obesity.

Leon Andrews, senior fellow of the Institute for Youth, Education and Families discussed work with First Lady Michelle Obama's Let's Move! campaign, in which all 50 states and over 450 school districts are participating. The initiative includes new nutrition standards for school meals and ideas for encouraging exercise. Andrews urged attendees to ask their elected officials to participate in the campaign if they aren't already. Share positive feedback and success stories with elected officials as well instead of just making requests, said Whitney Meagher, project director at the National Association of State Boards of Education. "They need to be reassured that they did a good job and that this is actually working."

Jasmine Hall Ratliff, a program officer for the Robert Wood Johnson Foundation, said every community has a slightly different culture of health, but everyone should have the option to make healthy choices no matter where they live. She recognized that fighting obesity is multifaceted, and children need to both eat better and move more. "There are many communities where access to healthy foods is impossible, and there are no playgrounds. We fund advocacy and policy change at various levels to make access to physical activity and good food the default instead of the exception." She recommended checking out preventobesity.net, a place to access resources and talk with other advocates.

Voices for Healthy Kids, a joint initiative of the American Heart Association and the Robert Wood Johnson Foundation, supports nonprofits working to prevent obesity through public policy, said Kim Milbrath, the initiative's southern regional manager. Its campaign focuses on policy in six areas: improving nutritional quality of snack foods in schools; reducing consumption of sugary beverages; protecting children from unhealthy food marketing; increasing access to affordable healthy foods; increasing access to parks, playgrounds and bike paths; and helping youth-serving programs increase children's physical activities. The initiative is funding projects in nine Southern states but not in Kentucky, at least yet.

Milbrath also offered practical advice for winning policy changes to fight obesity: Make sure you're including and informing the right people, including business groups, parents, school administrators, groups with political power and all those who share the goal. Messages should be carefully constructed to clearly express the purpose of the campaign and to personalize it to the audience's concerns. Recognize that contributions will vary, set clear expectations, decide exactly how the money will be used and include the issues important to the audience, like job creation.

Researchers say aggressively treating pre-diabetes could stop or delay future diabetic complications

Treating pre-diabetes as if it is diabetes could delay or prevent future related health complications, according to doctors from three leading research institutions and the American Diabetes Association, says a press release from the University of North Carolina School of Medicine.

The researchers writes in the journal Diabetes Care that "by not devising a treatment strategy for people with pre-diabetes, doctors run the risk of creating a pool of future patients with high blood sugar who then become more likely to develop serious complications, such as kidney disease, blindness, amputations, and heart disease."

Type 2 diabetes is diagnosed with a fasting blood sugar of 126 or higher; most of these patients are treated with medication. Prediabetes is diagnosed with sugar levels between 100 and 125, and the release says such patients are usually not treated aggressively.

"Diabetes is generally diagnosed and first treated about 10 years later than it could be. We waste this critical opportunity to slow disease progression and the development of complications," lead author Lawrence Phillips of Emory University said in the release.

Kentucky ranks 17th in diabetes, according to the 2014 "State of Obesity" report. The report projects that there will be an increase of 51 percent of people with diabetes in Kentucky by 2030, going from 394,029 people with diabetes in 2010 (or 10.6 percent) to 594,058. The Kentucky Cabinet for Health and Family Services reports an estimated 233,000 adult Kentuckians have pre-diabetes.

“We need to screen and track patients with pre-diabetes to manage their blood sugar more aggressively,” John Buse, professor of medicine and director of the UNC Diabetes Care Center, said in the release. “We’re very confident this would spare our patients serious health issues down the road.”

Evidence for this study comes from clinical trials where "lifestyle changes and/or glucose-lowering medications decreased the progression of pre-diabetes to Type 2 diabetes," says the release. The future development of diabetes also remained less in those who implemented these changes and then withdrew from them compared to a pre-diabetic control group who did not get any interventions.

Patients who achieved a normal glucose level, even for a short time during the trials, showed a "substantial reduction in subsequent development of Type 2 diabetes," says the release.

The authors say in the release that based on this evidence diabetes management should change to include regular screening in adults for pre-diabetes and early Type 2 diabetes and if a patient has either one of these conditions and is determined to benefit from treatment, they should get "management that will keep their blood glucose levels as close to normal as possible."

Most overweight diabetics don't know how much to exercise for weight loss, and they don't exercise enough

By Melissa Patrick
Kentucky Health News

Many overweight people with diabetes don't exercise enough for weight loss, and they also don't have a clear understanding of the recommended amount of exercise, according to a study reported by the Health Behavior News Service, part of the Center for Advancing Health.

The study, which looked at the exercise habits in people with diabetes, found that men with diabetes exercise more than women with diabetes, and, not surprisingly, that diabetic women who are trying to lose weight exercise more than those who aren't. But no one in the study was exercising the recommended amount for weight loss, according to the study report, published in American Journal of Health Promotion.

“We were not surprised that, overall, people with diabetes trying to lose weight were not engaging in enough physical activity,” study co-author Gina Pariser, associate professor at Bellarmine University in Louisville, said in a press release. "This finding emphasizes the need for health care professionals to provide more detailed and individualized education on exercise.”

Kentucky ranks 17th in diabetes and fifth in obesity, according to the 2014 "The State of Obesity: Better Policies for a Healthier America" report. It also says that more than 80 percent of people with diabetes are overweight or obese.

"Adults who are overweight or obese are at an increased risk for developing diabetes," the release notes. "Regular participation in physical activity may not only help reduce weight, but also help treat diabetes, and may prevent consequences associated with physical inactivity."

Health-care professionals need to do more than just encourage their diabetic patients to exercise, the researchers say in the release.

“Education about specific amounts of physical activity is needed to achieve goals such as weight loss and blood sugar control,” Pariser said. “Plus, instruction in the use of tools to objectively measure the amount of physical activity, like pedometers, should be provided.”

This study analyzed the association between exercise and weight control in 733 adults with diabetes and 4,572 without diabetes. Participants used a device to measure their physical activity and were asked if they were trying to lose weight, trying to maintain their weight or neither trying to lose nor maintain weight. For more information about diabetes and exercise, click here.

Study shows students, especially those with ADHD, have improved academic performance after they exercise

Children do better in school when they aren't forced to sit still all day, especially those with attention deficit hyperactivity disorder, Gretchen Reynolds reports in The New York Times.

Recent research, published last year in The Journal of Pediatrics, suggests that even small amounts of exercise enable children to improve their focus and academic performance.

The study looked at 40 boys and girls, age 8 to 10, half of whom had ADHD. Researchers gave the students a baseline academic test and also one that tested their attention. They then gave the same tests two more times, first after they had sat and read quietly for 20 minutes and the other after they had walked briskly or jogged 20 minutes on treadmills. Brain activity was recorded as they repeated the original tests.

Little difference was found in any of the students after quietly reading, but "they all showed marked improvements in their math and reading comprehension scores after the exercise," Reynolds writes. Students with ADHD showed significant increases on their scores and had brain-wave readings that showed them better able to regulate their behavior, which helped them pay attention.

"The results should make administrators question the wisdom of cutting P.E. classes," Reynolds writes.

This information is a valuable tool for educators, especially in Kentucky, which leads the nation with 19 percent of children ages 4 to 17, compared to 11 percent nationally, who have ever been diagnosed with ADHD, according to the federal Centers for Disease Control and Prevention. The level of exercise needed to show academic and attentional improvement involves activities that can be done in the classroom throughout the day, like marching or hopping in place.

Appalachian Kentucky has much of what it needs to improve its poor health status, key federal officials agree

By Al Cross
Kentucky Health News

Appalachian Kentucky has the enthusiasm, creativity, people and facilities needed to greatly improve its dismal health status, two high-ranking federal officials said after looking at the problem on a recent tour.

Dr. Thomas Frieden, Rep. Hal Rogers

"I want to stir up our people to get involved in a grass-roots effort," U.S. Rep. Harold "Hal" Rogers, R-Somerset, who hosted Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, on a four-stop tour of his Fifth Congressional District in early August.

Rogers and Frieden were guests on KET's "One to One" Sunday afternoon, in a program recorded right after they returned from their trip, where Frieden said he saw much creativity and enthusiasm.

Using one of Rogers's favorite sayings, Frieden said, "If you plan your work and work your plan, you may very well have tremendous success."

Rogers said what struck him most about the trip was "the infrastructure we already have in place," including hospitals, health departments, doctors and other health providers, and he wants to "talk about enhancing them.

Rogers is in a position to do that with federal money, because he is chairman of the House Appropriations Committee. He is also co-founder, with Democratic Gov. Steve Beshear, of Shaping Our Appalachian Region, an initiative to improve the economy of Eastern Kentucky.

Asked by "One to One" moderator Bill Goodman where the role of government begins and personal responsibility for health begins, Frieden said, in an apparent reference to smoking bans, "You don't want to go to your job and get cancer as a result."

"We don't tell people what to do" at the CDC, he said, but offer communities choices from a list of proven programs. Earlier, he said smoke-free laws not only reduce smoking, but heart attacks among non-smokers.

Rogers said he asked Frieden what one thing he would recommend for improving personal health in the region, and the doctor replied, "Walk."

Frieden said walking is an especially good option for Kentuckians because they have such a beautiful state. However, many rural areas in the state lack sidewalks or other easily accessible places to walk.

"Physical activity is the closest thing we have to a wonder drug" for all sorts of ailments, Frieden said, "but you have to do something you love to do" in order to stick with it. He said it also helps children be good students: "The more physical activity they get, the better their minds will work."

That point was made a few days before the two men's trip, at the Kentucky Summit on Childhood Obesity and Physical Activity at the University of Kentucky.
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